1 What is Autoimmune Pancreatitis?
As the name suggests, autoimmune pancreatitis (AIP) is a chronic condition of pancreatitis caused by autoimmune condition.
In this condition, the immune system attacks the tissues of pancreas.
This form of chronic pancreatitis responds to steroid therapy in controlling the symptoms.
There are two types of AIP – Type 1 (IgG4-related pancreatitis) and Type 2.
Type 1 AIP is a part of another condition called IgG4-related disease (IgG4-RD).
This disease affects many organs including
Type 2, on the other hand, affects only the pancreas, and most of the patients have associated
inflammatory bowel disease.
AIP is rare and is often misdiagnosed as
pancreatic cancer. Differential diagnosis of the condition is essential as AIP responds to steroid treatment.
Autoimmune Pancreatitis may remain asymptomatic in most of the cases. Signs and symptoms, when present, resemble that of
Common symptoms of the condition include
Pain in the upper part of the abdomen
Nausea and vomiting
Weakness and fatigue Loss of appetite
Unexplained weight loss
Blockage of the bile ducts cause jaundice, and this is the most common symptom of AIP. Autoimmune condition may cause formation of masses in the pancreas which is often misunderstood for tumor or
Type AIP is more commonly seen in males over 60 years. Many organs like
may be involved in the condition.
Type 1 is also characterized by the presence of fibrous tissue behind the stomach and intestine, a condition called as retroperitoneal fibrosis (RPF).
is also seen associated with this type of AIP.
Type 2 AIP is more commonly seen in people over 40 years, but is seen equally among males and females. Most of them have increased risk of
inflammatory bowel disease like ulcerative colitis.
As in many other conditions, Autoimmune pancreatitis is also caused by the autoimmune condition in which the immune system attacks pancreatic tissue.
The actual cause of autoimmune condition is not known.
4 Making a Diagnosis
Signs and symptoms of Autoimmune pancreatitis is similar to that of
pancreatic cancer, making diagnosis hard.
Misdiagnosis cause delay in treatment of the condition.
As per the International Consensus Diagnostic Criteria (ICDC), the diagnostic tests for AIP are
Imaging techniques like CT,
MRI, endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography ( ERCP) Serology
Other organ involvement
Response to steroid trial – a trial of response to steroids is used to confirm the diagnosis, as only AIP responds to steroid treatment
Blood test checks for the presence of immunoglobulin IgG4.
Elevated levels of these immunoglobulins indicate type 1 AIP.
Biopsy of pancreatic tissue shows the distinctive cells and tissues of the organ in AIP.
Several treatment methods exist for Autoimmune pancreatitis.
Draining the biliary ducts to remove obstruction in the ducts helps to control the symptoms.
This is done by inserting a tube into the ducts by a process called biliary stenting.
Drainage is suggested even when diagnosis is not confirmed.
Prednisone treatment often given immediate response to symptoms.
Corticosteroids like prednisone may have long term side effects.
To reduce the side effects, immunosuppressants or immunomodulators like
Pancreatic enzyme supplementation is often needed when enzymes are less.
Type 1 AIP is associated multiple organ involvement like
Continuous monitoring for organ involvement is also recommended in the treatment of AIP.
There is no standard preventive measure for Autoimmune pancreatitis, as the actual cause of the disease is not known.
Understanding and avoiding risk factors help to control the condition.
7 Alternative and Homeopathic Remedies
A few alternative and homeopathic remedies exist for Autoimmune pancreatitis.
Dietary changes and supplements are the natural remedies used in AIP.
Anti-inflammatory compounds like aloe and papaya juice are used in pancreatitis treatment.
These supplements control inflammation and offer relief from symptoms.
are also suggested.
Antioxidants are useful in reducing pain and improving health.
8 Lifestyle and Coping
Understanding the condition and the treatment strategies help in coping with Autoimmune pancreatitis.
Following a healthy diet helps to improve overall health of the patient.
Supplements should be taken only after recommendation from the doctors.
Corticosteroid therapy may cause several side effects.
9 Risk and Complications
Complications associated with Autoimmune pancreatitis are:
diabetes, pancreatic stone formation
Long-term use of steroids cause side effects.
10 Related Clinical Trials